2014 Papers - Dupaix


Skeletal Injuries Arising From Moped and Motorcycle Collisions

John Dupaix Orthopaedic Residency Program, University of Hawaii


Background: Motorcycle and moped injuries remain a significant cause of motor vehicle related morbidity and mortality both nationally and in the state of Hawaii. Mopeds remain a common and popular method of travel for both the local population and in the tourism industry of Hawaii. Few regulations or specialized training are required for their operation, however. While there is abundant literature describing the skeletal injuries sustained in motorcycle collisions, there is a paucity of literature describing the skeletal injuries of moped riders and how these compare to those of motorcycle riders. The purpose of this study is to describe the skeletal injuries sustained in such incidents by vehicle type and determine if there are significant differences.

Methodology: Patients traumatically injured on powered two-wheeled vehicles between 2004 and 2007 were entered into a trauma registry along with their presentation and clinical course. This registry was then segregated by vehicle type and reviewed for riders who sustained injuries of the appendicular skeleton, bony pelvis and spine. Injuries were then classified by bone injured. Additional data including gender, age, helmet use, head injury, facial fracture, ISS and mortality were extracted. Fisher's exact test was used to compare proportion of motorcycle and moped riders with injuries, Chi square testing was used to compare fractures sustained in all three vehicle types. ANOV A with pos-hoc Tukeys 's HSD was used to evaluate ISS on presentation.

Results: 406 of 578 motorcyclists, 197 of 357 moped riders and 62 of 92 dirt-bike riders entered in the trauma registry sustained fractures of the appendicular skeleton, pelvis and/or spine. Motorcyclists had a significantly higher ISS score upon presentation and were more likely to die within the first hospital day. They also sustained significantly more skeletal injuries than moped riders and more fractures of the upper extremity (hand, radius, ulna. scapula) in addition to significantly more fractures of the spine, pelvis and foot. In contrast, moped riders were more likely to sustain significant head injuries and facial fractures. This was associated with a significantly lower rate of helmet use.

Discussion and Conclusion: While both moped and motorcycle riders share a risk for injuries of the lower extremity, their overall pattern of injury differs. Motorcycle riders appear to be at increased risk for more severe injuries and injuries of the upper extremity, spine and pelvis, while moped riders are at increased risk for significant head and facial injury.